Jaimes Sandra L, Ramírez Carlos E, Viviescas Andres F, Abril Andres F, Flórez David F, Sosa Cristian D
Division of Plastic and Reconstructive Surgery, Burn Center, University Hospital of Santander, Universidad Industrial de Santander; Bucaramanga, Colombia.
University Hospital of Santander, Universidad Industrial de Santander; Bucaramanga, Colombia.
Indian J Plast Surg. 2022 Feb 9;55(1):75-80. doi: 10.1055/s-0041-1740494. eCollection 2022 Feb.
Burn wound infection (BWI) is the second most important cause of death in burn patients. There is currently limited data about the incidence and clinical presentation of BWI using quantitative techniques as quantitative biopsy culture (QBC) to prevent progress to burn wound sepsis (BWS). This is a prospective cohort study of patients diagnosed with BWI, confirmed by QBC, from February 2018 to July 2019 at University Hospital of Santander (HUS). The primary outcome was to determine clinical, microbiological, and histopathological characteristics of patients diagnosed with BWI along with a positive QBC and their relationship with early diagnosis and progression to BWS. 525 patients were admitted to HUS Burn Center. Of those, 44/525 (8.23%) presented a clinical diagnosis of BWI (median age, 20.5 years [1-67 years]; 25/44 [56.8%] male). QBC was positive in 26/44 (59%), 14/44 (31.8%), and 7/44 (15.9%) were the mainly etiological agents isolated. Bacterial resistance to antibiotics was mostly to beta-lactams in 14/44 (31.8%), corresponding to methicillin-resistant (MRSA). Clinical signs more related to infection were erythema in 33/44 (61.3%). As many as 10/44 (22.7%) progressed to sepsis and 2/44 (6%) died. BWI increases hospitalization time and number of surgeries, increasing the risk of sepsis and death. The QBC allows an accurate diagnosis with lesser false-positive cases that impact antibiotic resistance and mortality. Protocols targeting this problem are needed to decrease the impact of this.
烧伤创面感染（BWI）是烧伤患者死亡的第二大重要原因。目前，关于使用定量活检培养（QBC）等定量技术来预防烧伤创面脓毒症（BWS）进展的BWI发病率和临床表现的数据有限。 这是一项对2018年2月至2019年7月在桑坦德大学医院（HUS）被QBC确诊为BWI的患者进行的前瞻性队列研究。主要结果是确定经QBC确诊为BWI的患者的临床、微生物学和组织病理学特征，以及它们与早期诊断和进展为BWS的关系。 525名患者入住HUS烧伤中心。其中，44/525（8.23%）临床诊断为BWI（中位年龄20.5岁[1 - 67岁]；25/44[56.8%]为男性）。QBC阳性的有26/44（59%），分离出的主要病原体分别为14/44（31.8%）和7/44（15.9%）。14/44（31.8%）的细菌对抗生素耐药，主要是对β-内酰胺类耐药，即耐甲氧西林金黄色葡萄球菌（MRSA）。与感染更相关的临床体征是33/44（61.3%）出现红斑。多达10/44（22.7%）进展为脓毒症，2/44（6%）死亡。 BWI会增加住院时间和手术次数，增加脓毒症和死亡风险。QBC能实现准确诊断，假阳性病例较少，可减少对抗生素耐药性和死亡率的影响。需要针对这一问题制定方案以降低其影响。
